{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T16:03:36Z","timestamp":1776960216556,"version":"3.51.4"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"\n Background<\/jats:title>\n \n The mechanisms behind the association of atrial fibrillation (\n AF<\/jats:styled-content>\n ) and dementia are unknown. We previously found a significantly increased risk of dementia in\n AF<\/jats:styled-content>\n patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which\n AF<\/jats:styled-content>\n itself increases dementia risk, in addition to long\u2010term anticoagulation exposure.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A total of 10\u00a0537 patients anticoagulated with warfarin (target\n INR<\/jats:styled-content>\n 2\u20133), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included. Warfarin indication was for\n AF<\/jats:styled-content>\n (n=4460), thromboembolism (n=5868), and mechanical heart valve(s) (n=209). Patients in the latter 2 categories were included only if they had no prior history of\n AF<\/jats:styled-content>\n . The primary outcome was dementia. Patients with\n AF<\/jats:styled-content>\n were older and had higher rates of hypertension, diabetes, heart failure, and stroke.\n AF<\/jats:styled-content>\n patients experienced higher rates of total dementia (5.8% versus 1.6%,\n P<\/jats:italic>\n <0.0001), Alzheimer disease (2.8% versus 0.9%,\n P<\/jats:italic>\n <0.0001), and vascular dementia (1.0% versus 0.2%,\n P<\/jats:italic>\n <0.0001). A propensity analysis of 6030 patients was performed to account for baseline demographics differences. Long\u2010term risk of dementia remained significant in\n AF<\/jats:styled-content>\n patients compared with matched non\u2010\n AF<\/jats:styled-content>\n patients (total dementia: hazard ratio [HR]=2.42 [1.85\u20133.18],\n P<\/jats:italic>\n <0.0001; Alzheimer:\n HR<\/jats:styled-content>\n =2.04 [1.40\u20132.98],\n P<\/jats:italic>\n <0.0001; senile:\n HR<\/jats:styled-content>\n =2.46 [1.58\u20133.86],\n P<\/jats:italic>\n <0.0001). Low percent therapeutic range compared with a higher percent therapeutic range was associated with dementia risk in both\n AF<\/jats:styled-content>\n (26\u201350% versus >75%:\n HR<\/jats:styled-content>\n =2.51,\n P<\/jats:italic>\n =0.005) and non\u2010\n AF<\/jats:styled-content>\n groups (\u226425% versus >75%:\n HR<\/jats:styled-content>\n =3.92,\n P<\/jats:italic>\n <0.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The presence of\n AF<\/jats:styled-content>\n significantly increases risk of dementia, including Alzheimer's disease, compared with matched patients receiving warfarin anticoagulation for other reasons. Quality of anticoagulation management remains an important risk factor for dementia in all patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003932","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T07:13:00Z","timestamp":1468307580000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Atrial Fibrillation Patients Treated With Long\u2010Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long\u2010Term Warfarin for Other Indications"],"prefix":"10.1161","volume":"5","author":[{"given":"T. Jared","family":"Bunch","sequence":"first","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"},{"name":"Department of Internal Medicine, Stanford University, Palo Alto, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi T.","family":"May","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tami L.","family":"Bair","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian G.","family":"Crandall","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Cutler","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Day","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Mallender","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Osborn","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott M.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Peter","family":"Weiss","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott C.","family":"Woller","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.063"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595140"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.12.004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S1839"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00195-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.2161"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.08.013"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31820f2e38"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12776"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.070920"},{"key":"e_1_3_2_12_2","first-page":"1032","article-title":"Computerized management of chronic anticoagulation: three years of experience","volume":"129","author":"Rocha BH","year":"2007","unstructured":"Rocha BH, Langford LH, Towner S. 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Stud Health Technol Inform. 2007;129:1032\u20131036.","journal-title":"Stud Health Technol Inform"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.04.022"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008140"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31829a33d1"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02339.x"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12537"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.003932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:12:34Z","timestamp":1715595154000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.003932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,6]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7,6]]}},"alternative-id":["10.1161\/JAHA.116.003932"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.003932","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,6]]},"assertion":[{"value":"2016-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003932"}}